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A Cleveland Clinic review notes that one case report described symptoms only after a cumulative 15,000 mcg (15 mg) of injected B12 over several weeks

Post-Injection Guidance Patients can resume daily activities immediately, with results typically noticeable within hours to days

A typical maintenance schedule might look like one shot a week, every few weeks, or even just once a month

(Outlines contraindications for niacin therapy, including active peptic ulcer disease, active liver disease with elevated enzymes, hypersensitivity to niacin, and arterial bleeding, as well as monitoring recommendations for blood pressure, glucose, uric acid, etc., due to niacins systemic effects)